Quality of services

Basic concepts

The link between the availability of services and citizens’ well-being is based on an interpretive approach in which high quality public investments improve the general context in which people live and work and their social and economic interconnections. The choice of services to be taken as a reference depends on two distinct considerations relating to what qualifies a service as essential in the specific context of a policy, and what conditions must be met to define feasible targets. The identification of services and quality of performances depends on the different level of development, which increases the level and types of services seen as essential. For example, in more developed contexts, the minimum set of health services refers to a wider range of treatments. Aspects of equity and distribution, that is the connection between individual income and availability of services, are also relevant: the inadequate availability of services particularly affects those who do not have sufficient income conditions to resort to alternatives, while the non-availability of basic services is in itself a factor of poverty and exclusion. In this framework poverty is understood as the deprivation of opportunities and basic assets to which every person is entitled (nutrition, basic education, access to health services, water services, the possibility of participation in social and political life, ability to work, …). This implies that inadequate services directly worsen the conditions of marginalization and exclusion, and therefore, decisive action on improving quantity and quality of services contributes directly to the reduction of social exclusion and poverty.

Dimensions considered to represent the domain

Based on the recent work of the Department of Public Administration (DFP, 2010) to assess the actual quality of public services, the Independent Commission for the Evaluation and Transparency of Government (Civit) identified the relevant dimensions for measuring quality of public services. “The analysis of the quality of a service indicates how and to what extent an organization delivers quality services, which comply promptly, consistently and fully to the requests of potential users, minimizing the trouble, the number of steps necessary, inconvenience caused by disruptions”. It does not include the quality of the delivery process, rather involving aspects of efficiency, affecting only indirectly the citizen, or the subjective perception of users. The Commission identifies four essential dimensions: accessibility, timeliness, transparency and effectiveness. Here, the dimensions of transparency and timeliness (for which, however, the statistical information is extremely scarce) are considered as elements of accessibility or effectiveness, which are therefore consider as central dimensions of quality.
Even if infrastructures supply are in most cases only a pre-requisite for the achievement of a high standard in the delivery of services, in some cases aspects of infrastructures supply were taken into account as proxy of accessibility.
Furthermore, also on the basis of information provided by the CNEL-ISTAT Steering Committee, of criteria of data availability parsimony of indicators, the thematic group proposes to structure the analysis through three main areas of services: social services (health and social care), public utilities (energy, water and waste) and mobility. Therefore, it is possible to analyze each of the three main areas of services through the dimensions of accessibility and effectiveness.

List of indicators

Beds in residential health care facilities: Beds in residential health care facilities per 1,000 inhabitants The availability of beds in these facilities meets the requirements associated with the progressive aging of the population. This indicator is a proxy for the accessibility of the elderlies to these facilities, needed to meet health and social needs.

Taking charge of users for early childhood services: Percentage of children aged zero to two years who benefited of early childhood services (crèches, micro-crèches or supplementary and innovative services) on total population aged 0-2.
The proportion of children receiving the services for early childhood is a useful indicator to measure the implementation of policies to reconcile the family and work commitments and to promote women’s employment. At this service is assigned also a key part of regional policy, drawn and de-scribed in 2007-2013 National Strategic Framework (NSF).

Taking charge of the elderly for home assistance: Percentage of elderly people who benefited from integrated home assistance service (Adi) on total population aged 65 and over.
The integrated home assistance is an essential service for frail elderly people and offers relief care for family members. This indicator measures the effectiveness of the system in providing medical, nursing and rehabilitative assistance, aimed at improving, maintain or restore the health state and level of independence of the elderly in need.

Irregularities in electric power distribution: Frequency of accidental long lasting electric power cuts (cuts without notice longer than 3 minutes) (average number per consumer).
The interruptions of power create important discomfort for both domestic and economic activities. Furthermore, the irregularity of the service may, in extreme situations, create a damage to human health (eg in cases where you use electrical equipment).

Percentage of household served by methane gas: Percentage of household declaring that the apart-ment is supplied with methane gas on total number of households.
The indicator measures the degree of territorial spread of the local gas network, expressed in terms of population served. Access to methane gas is a form of service to citizens and businesses that allows the diversification of the use of renewable energy for home use or in support of productive activities, easy to use in terms of capillary distribution infrastructure, which ensures saving in terms of scale economies for producers and environmental benefits in terms of polluting emissions released into the environment compared to those produced by the use of other fossil fuels. In view of these factors has been the subject of government incentive policies dedicated favoring its widespread use, particularly in the more backward regions.

Irregularities in water supply: Percentage of households who report irregularities in water supply on total number of households.
The irregularity of the water distribution involves significant inconvenience for citizens given the daily and diverse use of water resources. As a basic need service, its irregular supply has significant negative impact on the quality of life of households.

Separate collection of municipal waste: Percentage of municipal waste object of separate collection on total municipal waste.
The percentage of municipal waste object of separate collection describes the ability of citizens to ac-cess the service but also the activation of good practices in municipal waste management. In this con-text, the indicator is also used as a proxy for the overall quality of the service of waste collection and for the ability to reach the largest number of citizens. The growth in the proportion of waste collected in differentiated form (set as an objective by the European legislation on waste and as such also adopted with the determination of target levels in national laws) is a prerequisite to reducing the amount of waste sent to landfill. Therefore it has a significant positive impact on the overall quality of the environment and indirectly on the health and quality of life of citizens.

Prison density : Percentage of prisoners in penal institutions on the total capacity of penal institutions.
The indicator allows to have an overview of the quality of life of prisoners.

Time devoted to mobility: Minutes devoted to mobility on an average weekday.
Several studies show that the time spent travelling has negative effects on health and quality of life. The increase in the time spent on mobility necessarily reduce the time spent on other activities, primarily leisure time.

Place-Km of public transport networks: Number of train/vehicle km in the year (all public transport ve-hicles) multiplied by the average capacity of the vehicles (fleet) per inhabitant.
Local public transport is of value to the citizens well-being in many ways: a network with extensive and efficient coverage reduces the congestion of the city and its rise time of movement for citizens; it limits the economic costs of travelling, and guarantees improved air quality through the use of a smaller number of vehicles (being equal the number of passengers transported) and the diffusion of modes of transport by rail which are alternative to the traditional road transport.

Composite index of service accessibility: Percentage of households who find very difficult to reach three or more basic services (pharmacy, emergency room, post office, police, carabinieri, municipal offices, crèches, nursery, primary and secondary school, market and supermarket) on total number of households.
The index summarizes the degree of satisfaction of citizens with regard to a large group of different services but of great importance, it is a measure of the extensive coverage of services to citizens in the area. It is possible to decompose the figure for each of the services covered by the index and therefore see which service records the most critical aspects.